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Catheter thrombosis

G A Beathard1

  • 13805 Green Trails South, Austin, Texas 78731, USA. gerald@beathard.com

Seminars in Dialysis
|February 20, 2002
PubMed

Insights

Catheter malfunction, often caused by fibrin sheath thrombus, requires prompt treatment to ensure adequate dialysis. While urokinase is unavailable, recombinant tissue plasminogen activator (tPA) shows promise, but catheter exchange remains the current best solution.

Area of Science:

  • Nephrology
  • Vascular Access Management

Background:

  • Catheter malfunction, particularly due to poor flow, is a frequent complication in dialysis.
  • Early malfunctions are typically technical, while late issues often stem from thrombus formation, most commonly the fibrin sheath thrombus.

Purpose of the Study:

  • To review the causes and management of catheter malfunction in dialysis.
  • To explore potential therapeutic alternatives following the unavailability of urokinase.

Main Methods:

  • Literature review on catheter malfunction causes and treatments.
  • Discussion of thrombus types and formation mechanisms.
  • Evaluation of recombinant tissue plasminogen activator (tPA) as a potential alternative.

Main Results:

  • Fibrin sheath thrombus is the most prevalent cause of late catheter malfunction.
  • Urokinase, a previous treatment, is no longer available.
  • Recombinant tissue plasminogen activator (tPA) is a potential but not optimally packaged alternative.

Conclusions:

  • Prompt treatment of catheter malfunction is crucial to prevent inadequate dialysis.
  • Catheter exchange is currently the most reliable management strategy for catheter malfunction.
  • Further development of tPA packaging is needed for optimal use in this context.

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